The medical profession is full of important ethical issues. In this lesson, explore three major ethical concerns and discover how they relate to medicine. Then test your understanding with a brief quiz.
Medical Ethics
Today, I’m thinking about taking a tour of an institution where some of the greatest philosophical debates in the modern world are being held. Questions of ethics, morality, justice, fairness, rights, and responsibilities – all right here. That’s right – we’re heading to the hospital!The world of medicine has been full of ethical issues for millennia, and some of the oldest moral codes in Western history deal with the rights and obligations of medical professionals. So if you’re looking for a chance to discuss philosophy, there’s really no better place to go for a nice, healthy debate.
Truth Telling
Tell the truth. That’s a pretty basic moral rule that we’re taught early on, but it’s also a major ethical concern in medicine. Truth telling in medical ethics involves the moral duty to be honest with patients about conditions, medications, procedures, and risks, and this can often be unpleasant, but it is generally necessary.
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As recently as the 1960s, most physicians believed that patients would rather be lied to than told a horrible truth. However, this attitude fostered a large amount of distrust between physicians and patients, and trust is pretty important in this field. So modern medical ethics insist on honesty and openness.Still, it’s not as easy as it sounds. What if telling the patient the whole truth could interfere with the doctor’s primary moral duty, which is to do no harm? Honesty is still preferred, but there are two situations where it is considered acceptable to not be completely truthful.
First, the physician may withhold some information if they truly believe that complete honesty will lead to greater harm, an ethical right called the therapeutic privilege. A fear of suicide in patients suffering from depression is an example of this.The second situation is if the patient makes a conscious, informed statement that they don’t want to know the entire truth.
Maybe they want a family member to make medical decisions, for cultural or personal reasons. Maybe they are afraid that bad news will make them lose hope, while not knowing will encourage them to keep trying to get better. Both of the exceptions from truth telling are important to medicine but have to be treated very, very cautiously so that they are not abused.
Confidentiality
Amongst the ethical principles of medicine, another major one is confidentiality, or the obligation of a physician to keep a patient’s health information private. This is pretty important, since patients have to trust their physicians but may be afraid to honestly admit to illegal or dangerous activity. Maybe they don’t want the cops to know that they were doing drugs; maybe they just don’t want their mom to know that they were being reckless.
However, both of these things are really important for physicians to know before administering treatment. So as long as you’re over 18, physicians cannot reveal anything that you tell them about your personal health without your written consent.Again, there are a few exceptions. If the patient reveals information that could put others at risk, doctors may share it. For example, say someone with a mental disorder admits that they intend to commit a violent crime.
Technically, that admission was confidential since it deals with their mental health, but it also clearly suggests a threat to other people, so the doctor may share that information with police. The other exception is with major communicable and sexually transmitted diseases. In the name of public health, physicians are required to report specific conditions, like AIDS, tuberculosis, or anthrax, so that public health officials can track and prevent the spread of disease. In this exception, the greater good is seen as more important than individual liberty and rights to privacy.
Informed Consent
All right, we arrive at the last of the three big ethical issues in medicine. Informed consent is the obligation of physicians to fully discuss treatment options with patients and get their permission to proceed. This stems from the medical ethical principle that patients should ultimately have control over their own bodies.
So physicians are expected to make patients fully aware of the process, risks, benefits, side effects, and expected results of every medical treatment option. Then, being fully informed, the patient has the final say as to whether or not they want to go ahead or try something else. This is where the ethics of truth telling and confidentiality come back into play. Physicians need to be honest and open so that the patient is able to fully understand their treatment options, and they need to feel safe discussing those options. But again, is it okay to omit a few minor side effects so that the patient isn’t overwhelmed by too much information? The debate continues, and so medical ethics is still a healthy source of discussion.
Lesson Summary
Medicine is one of the areas where ethics are most often applied and where ethical decisions have real impacts on people’s lives. There are a few fundamental moral issues in medicine, the first being truth telling, or the moral obligation of the physician to be honest with patients.
Generally, physicians are expected to be fully truthful about conditions and treatments, but there are exceptions if full honesty could lead the patient to greater harm or if the patient states a preference to not know the truth. Another ethical concern is confidentiality, the moral obligation of a physician to keep personal health information private. Anything you tell a physician must be kept private, unless it suggests harm to another person or is a case of certain communicable diseases that need to be tracked. All of this is wrapped up in the idea of informed consent, the moral obligation of physicians to fully discuss treatment options with patients, who then have the final decision about which option to pursue. With these ethical guidelines, patients can trust physicians to do their jobs, provide the best treatments, and keep everyone healthy.
Overview of the Importance of Truth Telling, Confidentiality ; Informed Consent in Medicine
 |
| Terms | Definitions |
|---|---|
| Truth telling | (with respect to medical ethics) involves the moral duty to be honest with patients about conditions, medications, procedures, and risks |
| Therapeutic privilege | physician may withhold some information if they truly believe that complete honesty will lead to greater harm |
| Confidentiality | the obligation of a physician to keep a patient’s health information private |
| Informed consent | the obligation of physicians to fully discuss treatment options with patients and get their permission to proceed |
Learning Outcomes
Test your knowledge of the lesson by achieving these goals:
- Recognize the need for truth telling between doctors and patients
- Realize the need for therapeutic privilege
- Explain why confidentiality is necessary in the medical field
- Indicate why patients are entitled to informed consent
